I am Navy HPSP and I just found out I failed the COMLEX by 1 point. I have gone into study mode and am prepare to crush my re-take. However, I can't shake the thoughts in my head that I have completed screwed myself out of a residency. From what has been explained to me so far is that in the Navy you're pretty much destined for GMO service with few exceptions. Before this I have to match into a Transitional Year PGY-1. I have had some tell me that due to my boards failure, I may not match in the military at all and I will have to look to see if I can find a residency on the civilian side. Now my question is, would I have to match into a Transitional Residency? From what I gather, those are competitive because those going into Derm or Rads have to apply for them. Am I correct in this thinking? Does anyone know in what specialty and locations there were unfilled residencies this/last year?

I truly hope I can match through military and not have to worry about the civilian match at all, but in the event that I do what is the best route for someone with a Step 1 fail?

My grades are pretty middle of the road.
Honors in first two rotations.
Multiple published research
Prior military service
Was looking to specialize in EM but FM/IM would be great too.

You're not the first person this has happened to. Pass on your second try. You'll very likely match to some Navy internship. You'll probably have to do a GMO tour, as most people do regardless of board scores, but maybe not for FM/IM. You'll be OK.

I can't speak specifically for the Navy, but I can speak for the law of averages. COMLEX and USMLE have a failure rate. Not everyone passes, and not all those that fail are shunned for all eternity. If you pull yourself up, especially if you do very well on a retake, you always have the ability to say you had a bad test day. It happens.
To be frank, you're probably not going to match into dermatology. But that's because ultra-competitive residencies are looking for reasons not to accept the plethora of applications that they receive. But FM, IM and the like don't usually have that issue, and a good explanation accompanied by a turn-around score will get you in.

Rank IM or FP internship first (putting IM Portsmouth top is your best bet). You can still do another specialty post GMO but this will increase your chances of getting your foot in the door. Rotate as a 4th year and make them believe you want to be an internist.

Thank you for the support and encouragement. It's almost impossible to not feel defeated considering all the information out there saying "your application wont even be looked at". I need to shake that mindset and get this test taken care of so I can start prepping for Step 2.

Obvious advice, but you should analyze why you failed the first time. It's easy to get all jazzed-up and say, "this time is for real" and talk about crushing the test, but now is the time for a measured approach to your study regimen. Again, obvious, but our professors always espoused doing as many Qbank questions as possible, without a real emphasis on the percentage you were getting correct, but rather with the goal of experiencing as many concepts as possible with supposed learning along the way. I'd recommend like 200 questions/day if possible. It helped to also take notes on subjects that I could read about in more detail later. This strategy worked well for me. Good luck.

Obvious advice, but you should analyze why you failed the first time. It's easy to get all jazzed-up and say, "this time is for real" and talk about crushing the test, but now is the time for a measured approach to your study regimen. Again, obvious, but our professors always espoused doing as many Qbank questions as possible, without a real emphasis on the percentage you were getting correct, but rather with the goal of experiencing as many concepts as possible with supposed learning along the way. I'd recommend like 200 questions/day if possible. It helped to also take notes on subjects that I could read about in more detail later. This strategy worked well for me. Good luck.

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I completely agree. Trust me, Im not overly-confident, all the contrary actually. I am approaching my studying as you mentioned but also trying to not be too psyched out even though Im scared out of my mind! The first thing I did was download the test breakdown. I started my studying by focusing on the areas with "poor performance". The problem with this approach is that the next test wont be broken down similarly. My days vacillate between intense, focused studying and similar levels of panic.

That seems like a good strategy. Regardless of which test you take, they all test the same material. Buffing your CONCEPTUAL knowledge of these basic areas will serve you well on the real test. Strive to know "why" when you're reading the qbank explanation and you'll have a good groundwork for success. Serious though, my practical advice is to do 200 questions/day for like 4-6 weeks with that being the backbone of your regimen. Supplement with readings geared toward concepts where your knowledge is weak. I don't see how you could fail with this strategy.

Unless something has changed over the past few years...it is hard to not be accepted into NAVY GME unless you don't graduate medical school. I don't remember the last time I heard about a Navy deferment because of filling.

Bottomline...get through med school and pass your COMLEXes and you should be fine.

Unless something has changed over the past few years...it is hard to not be accepted into NAVY GME unless you don't graduate medical school. I don't remember the last time I heard about a Navy deferment because of filling.

Bottomline...get through med school and pass your COMLEXes and you should be fine.

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While that's what I too believed, while at ODS I had one of presenters tell me that there was a possibility I would not match in the Navy due to my failure. Of course, that sent my head spinning because what does that mean? That I have to match civilian? That I should be appying to civilian sites for residencies for one year and then reapply to match or would I have to go through a full civilian residency? Up to now, all I had read was that civilian deferments were a rarity saved only for the very exceptional candidated the military did not have a spot for (even then not likely).

While that's what I too believed, while at ODS I had one of presenters tell me that there was a possibility I would not match in the Navy due to my failure. Of course, that sent my head spinning because what does that mean? That I have to match civilian? That I should be appying to civilian sites for residencies for one year and then reapply to match or would I have to go through a full civilian residency? Up to now, all I had read was that civilian deferments were a rarity saved only for the very exceptional candidated the military did not have a spot for (even then not likely).

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I would contact Navy GME and ask the simple question, "Was there a single Navy medical student in recent history who did not match to a Navy internship?" I am pretty sure that the answer will be no. If you apply to both IM and FP, you are likely ensured a residency spot.

I would contact Navy GME and ask the simple question, "Was there a single Navy medical student in recent history who did not match to a Navy internship?" I am pretty sure that the answer will be no. If you apply to both IM and FP, you are likely ensured a residency spot.

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You would be surprised how many people want to do IM in the Navy nowadays, no cake walk

You would be surprised how many people want to do IM in the Navy nowadays, no cake walk

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I did a Navy IM internship, so I know. But still...IM is not as competitive as Transitional. Assuming he doesn't want to do Peds...I would say that IM and FP are the least competitive. 90% of the IM interns at NNMC were gunners...excellent interns. The others were folks that it was clear that the Navy had no other place to put them...including one who was a complete liability (two Comlex failures). The San Diego internships tend to be more competitive than Bethesda and Portsmouth. If I was in his boat I would rank the IM programs first...then have FP as a fall back plan. Don't bother with transitional...he likely won't get it.